The Correative Study Between CT Perfusion Onspiral CT Intensity And Agiogenesis In Cervical Carcinoma

Objective:To analyze the characteristics of the CT perfusion parameters PF(perfusion), BV(blood volume), PEI(peak enhancement image),TTP(time to peak ), TDC (time density curve) and the relationship between the perfusion, imaging appearance and MVD of cervical carcinoma.Materials and method:CT enhancement scan and perfusion scans were performed in 31 patients who were diagnosis cervical carcinoma in West china second hospital from November 2006 to March 2007,age from 20 to 70. 24cases are squamous carcinoma,7 cases are adenocarcinoma. 15 cases contrast tissue are normal tissue of cervical of some cervical carcinoma patients.All patients perform bowel and vagina preparation before scanning pelvic by CT . Plain scan performed at first with thickness 5mm by Philips Brilliances 6 CT. The biggest slice of tumor was selected to perform CT perfusion. Perfusion scan parameters were as follows: 120KV, 100mAs, thickness 6mm, scan time 0.75s, the total exposure time 80s, delayed time 9s,scan cycle 40,4 imaging / cycle, total imaging 160. 50ml contrast media (Iopamidol 370mgI/ml) was injected with a power injector at a flow rate of 5.0ml/s. All perfusion parameters of tumor were analysis in perfusion software of CT. All 31cases t were intensity scan after CT perfusion. The scan parameters as follow: 120KV, 100mAs, thickness 5mm, delayed time 35s,scan pitch0.9 , collimation 6×1.5,40-50ml contrast media (Iopamidol370mgl/ml) was injected with a power injector at a flow rate of 2.5-2.8ml/s. The primitive date were use to construct thin image, thin image thickness is 2mm, -1mm distance. All images were performed MPR. Two experienced doctor analysis the imaging characteristic of plain and intensity imaging, MPR imaging. At last analysis the relation between these appearances and MVD.Paraffin slides of these excised tumors and selected normal tissue of para-tumor were immunohistochemistry stained CD34 using SP(streptavidin/peroxidase) method. The MVD of each slide were quantified.The data was analyzed through using the SPSS 13.0. Pearson correlation analysis were performed to analyze the relationship between the CT perfusion parameters and MVD of cervical carcinoma. P value of less than 0.05 was considered to indicate statistical difference.Result:1. Some perfusion parameters of tumor group and normal cervical tissue group were statistical differences (P<0.05). The PF, BV, PEI of tumor group were higher than that of normal cervical tissue group. TTP of tumor group was shorter than that of normal cervical tissue.2. MVD between some groups were statistical differences (P<0.05) . MVD of tumor group were higher than that of normal cervical tissue group. The clinical stage had positive correlation to corresponding MVD values. The PF,PEI of tumor had positive correlations to corresponding MVD values. 3. The PF of squamous carcinoma group had correlations to corresponding MVD values; The PF,PEI of poorly differentiated group had correlations to corresponding MVD values; The PF,PEI,BV of II -III stage group had correlations to corresponding MVD values; The PF of lymph metastasis or non-lymph metastasis group all had correlations to corresponding MVD values;4. CT stage had consistency with clinical stage (Kappa = 0.5, p<0.05). Multi-slice spiral CT imaging appearance that are necrosis of tumor and metastasis of lymph node had positive correlation to corresponding MVD values. Enlarged cervical and invaded paracervical had not positive correlation to corresponding MVD values.Conclusion:The characteristics of perfusion imaging of cervical carcinoma are different from those of normal cervical tissue in PF, PEI, TTP and BV. PF and PEI of cervical carcinoma were positive correlation to corresponding MVD values. CT perfusion is a new method to know the angiogenesis of cervical carcinoma. It will be helpful to optimize strategy and forecast the patient's prognosis. Multi-slice spiral CT can offer more diagnosis information through MPR imaging. CT stage had consistency with clinical stage Some appearances had correlation to corresponding MVD values.